Patients With an ‘Empathic’ Doctor Have a Reduced Risk of Early Death
Patients who have been diagnosed with diabetes are at a lower risk of early
death if they have a doctor who they describe as showing empathy towards them,
a new study from the University of Cambridge has found.
Empathy is a high priority for patients.
It is an important concept within healthcare, in theory and despite
being emphasized in policy, codes of practice, national clinical guidance and
medical training, it is not actively supported in reality. In a healthcare
context, empathy refers to care that incorporates understanding of the patient
perspective, shared decision making between patient and practitioner, and
consideration of the broader context in which illness is experienced.
Optimizing management of diabetes is a public health priority given the
growing prevalence of the disease. Type 2 diabetes affects around 4 million
people in the UK, and is associated with significant risk of death from heart
disease and stroke and with early death. Type 2 diabetes is estimated to cost
the UK over £9billion annually, 10% of the UK NHS budget.
Researchers at Cambridge followed up 867 individuals across 49 general
practices in the UK as part of the ADDITION-Cambridge study to examine the
association between primary care practitioner (GP and nurse) empathy and
incidence of cardiovascular disease events (such as heart attack and stroke) or
Twelve months after diagnosis, patients assessed their GP’s empathy and
their experiences of diabetes care over the preceding year using the
consultation and relational empathy (CARE) questionnaire. The researchers then
divided their CARE scores into three groups.
The results of the study are published today in the Annals of Family
Of the 628 participants who completed the questionnaire, just under one in
five (19%) experienced a cardiovascular disease event and a similar number
(21%) died during follow up from causes including cancer and heart attack.
Those patients reporting better experiences of empathy in the first 12
months after diagnosis had a significantly lower risk (40-50%) of death over
the subsequent 10 years compared to those who experienced low practitioner
empathy. Participants experiencing better empathy also tended to have a lower
risk of cardiovascular disease events, although this was not statistically
“In trying to manage the growing burden of chronic preventable disease,
we’re increasingly moving towards precision healthcare, target-driven care and
technology-based assessment, while at the same time focusing less on the human,
interpersonal empathic aspects of care,” says Dr Hajira Dambha-Miller, a
GP and researcher at the Department of Public Health and Primary Care,
University of Cambridge.
“Our findings suggest that these more human elements of healthcare
early in the course of diabetes, may be important in their long-term health
outcomes. The potential impact is considerable and is comparable to prescribing
medicines but without the associated problems of side effects or
The researchers say there are several possible explanations for the
association between greater empathy and better health outcomes. Previous
studies have suggested that patients with lower levels of anxiety or those with
an optimistic outlook (and who are more likely to report better perceptions of
care), are also likely to live for longer.
They say it is also possible that GPs with empathic, patient-centered skills
may be more likely to succeed in promoting positive behavioral change such as
medication adherence or physical activity. Previous studies have also reported
that greater practitioner empathy is associated with higher patient motivation
towards activation, enablement and self-management of disease. Practitioner
empathy may also reflect the doctor’s listening ability and the trust of the
patient in disclosing what is really wrong so that it can be addressed.
Dambha-Miller, H et al. Association between primary care
practitioner empathy, and risk of cardiovascular events and all-cause mortality
amongst patients with type 2 diabetes: a population based prospective cohort
study. Annals of Family Medicine; 8 July 2019